The Effectiveness of Tuberculosis Education Programme in Kelantan, Malaysia on Knowledge, Attitude, Practice and Stigma Towards Tuberculosis among Adolescents.

BACKGROUND: Tuberculosis (TB) is contagious and the transmission risk is high in congregate settings like school. Incidence of TB among adolescents is significantly high hence an education programme was developed to improve knowledge, attitude, practice and stigma (KAPS) among them. METHODS: This school-based, non-randomised controlled study was conducted among secondary school students with a total of 236 respondents. The KAPS score were assessed before and 1 month after using self-administered validated KAPS questionnaire on TB. Analysis was done using repeated measures ANOVA. RESULTS: The mean percentage score (SD) for baseline knowledge, attitude, practice and stigma score for the respondents were 54.0 (4.48), 65.6 (1.74), 70.0 (1.43) and 66.0 (6.88), respectively. There was a significant difference (P < 0.001) in the knowledge and stigma score for intervention group compared to control group, adjusted for gender, ethnicity and smoking status 4 weeks post-TB educational programme. However, with regards to attitude and practice score, there was no significant difference (P = 0.210 and P = 0.243, respectively). CONCLUSION: TB education programme was effective in improving knowledge and stigma related to TB. This health education programme can be used as one of the strategies for the prevention and control of TB in schools.

HIV-related characteristics among female partners of injecting drug users in Kelantan, Malaysia: a descriptive study.

Kelantan, a northeastern state in Peninsular Malaysia, is one of the states that has been acutely hit by injecting drug user (IDU)-driven HIV epidemic, in addition to having a high number of infected women in Malaysia. This cross-sectional study describes the socio-demographic characteristics, HIV risk factors, risk perception, and adoption of preventive behaviors among female partners of IDUs in Kelantan. Out of 101 women, the majority of them are from low socioeconomic background and have no other risk factors besides heterosexual HIV transmission from their male IDU partners. Although 45.5% have not been tested for HIV and more than half (53.5%) of them did not use condoms during sexual intercourse, only 44.6% of the women perceived themselves to be at risk of being infected with HIV. Most of the women (86.1%) were willing to undergo voluntary counseling and testing (VCT). Female partners of IDUs continue to be vulnerable to HIV due to having sexual contact with IDUs, and also due to their socioeconomic position in the community. To prevent HIV transmission among female partners of IDUs, consolidating HIV prevention efforts from multiple approaches is needed.

Knowledge, Awareness, and Practice of Safety and Emergency Response Among Scuba Divers in Malaysia: Questionnaire Development and Validation.

INTRODUCTION: Safety has become paramount to ensure that scuba diving continues to expand into new markets, with minimal risks, and that scuba diving translates into a safe and relaxed adventure in response to growing market demands. Research focusing on assessing the knowledge, awareness, and practices (KAP) regarding safety and emergency response among scuba divers has been limited, and there is a need for validated assessment tools in this area. METHODS: This study involved 555 scuba divers in Malaysia, and the questionnaire underwent a thorough development and validation process, including content and face validity assessments, as well as exploratory factor analysis. The validation of the knowledge domain was conducted using Item Response Theory (IRT) analysis, while awareness and practice were validated through exploratory and confirmatory factor analyses (EFA and CFA). RESULTS: The content validity of the instrument was confirmed, with all items scoring over 80% for Item Content Validity Index (I-CVI), Scale Content Validity Index (S-CVI), and Scale Content Validity Index/Average (S-CVI/AVE). The initial draft comprises three domains: knowledge, awareness, and practice. Knowledge items were analyzed using IRT and demonstrated acceptable difficulty and discrimination levels. For the awareness and practice domains, EFA showed a Kaiser-Meyer-Olkin measure (KMO) of 0.83 and 0.79, respectively, with a significant Bartlett's test of Sphericity (P < 0.001). EFA yielded three factors for both awareness and practice domains with a total of 12 items for awareness and 13 items for practice, with satisfactory factor loadings (≥0.3). The final model of CFA showed good fits for both awareness and practice domains in terms of absolute, parsimonious, and comparative measures. The composite reliability of awareness was acceptable with Raykov's rho of 0.71, whereas the practice domain fell slightly below the acceptable threshold at 0.55. This was attributed to low factor loading and a limited number of items within each factor. The final questionnaire now consists of 20 items for knowledge, 10 items for awareness, and 12 items for the practice domain. CONCLUSION: The results of this validation and reliability study indicate that the newly developed questionnaire possesses favorable psychometric properties for assessing KAP related to safety and emergency response in the scuba diving context. This research is essential for harmonizing the perspectives of crucial stakeholders within the recreational scuba diving industry.

Development and Validation of the Observation Checklist Assessing the Hygiene and Sanitation of the Food Preparation Areas in Kota Bharu Kelantan Preschool.

INTRODUCTION: The current inspection checklist for the assessment of food preparation areas in preschools in Malaysia has not been revised since 2012. The checklist's content needs to be improved to ensure relevant parameters are covered during preschool inspections. OBJECTIVE: The objective of this study was to develop and validate an observation checklist for assessing the hygiene and sanitation of food preparation areas in preschools. METHODOLOGY: The study was conducted in Kota Bharu Kelantan from March 2021 to February 2022. The development of the observation checklist was conducted in four stages: (1) the construction of domains and items from the existing literature, (2) content validation by six experts (using the item-level content validity index (I-CVI) and the scale-level content validity index (S-CVI), (3) face validation by 10 experts (using the item-level face validity index (I-FVI) and the scale-level face validity index (S-FVI)), and (4) reliability analysis (using the intercorrelation coefficient (ICC)). Four assessors performed the reliability analysis at two preschools. RESULTS: The initial draft of the checklist contained three domains and 57 items: building and facility (10 subdomains and 38 items), process control (four subdomains and 12 items), and food handlers (one subdomain and seven items). The I-CVI scores for building and facility, process control, and food handlers were 0.97, 1.00, and 1.00, respectively, indicating good relevancy of items. The S-CVI value was 1.0 for all domains, showing good relevance of the items. The I-FVI above 0.8 and S-FVI values above 0.9 for all domains imply that the participants easily understood the checklist. The ICC for each domain was 0.847 (95% CI 0.716-0.902) for the building facility and 1.0 for process control and food handler, and the ICC for the three domains combined was 0.848 (95% CI 0.772-0.904). The final validated checklist consists of three domains with 57 items. CONCLUSION: The newly developed observation checklist is a valid and reliable tool for assessing the hygiene and sanitation of preschool food preparation areas.

Randomized Clinical Trial on the Use of PHYSTA Freeze-Dried Water Extract of Eurycoma longifolia for the Improvement of Quality of Life and Sexual Well-Being in Men.

Eurycoma longifolia is reputed as an aphrodisiac and remedy for decreased male libido. A randomized, double-blind, placebo controlled, parallel group study was carried out to investigate the clinical evidence of E. longifolia in men. The 12-week study in 109 men between 30 and 55 years of age consisted of either treatment of 300 mg of water extract of E. longifolia (Physta) or placebo. Primary endpoints were the Quality of Life investigated by SF-36 questionnaire and Sexual Well-Being investigated by International Index of Erectile Function (IIEF) and Sexual Health Questionnaires (SHQ); Seminal Fluid Analysis (SFA), fat mass and safety profiles. Repeated measures ANOVA analysis was used to compare changes in the endpoints. The E. longifolia (EL) group significantly improved in the domain Physical Functioning of SF-36, from baseline to week 12 compared to placebo (P = 0.006) and in between group at week 12 (P = 0.028). The EL group showed higher scores in the overall Erectile Function domain in IIEF (P < 0.001), sexual libido (14% by week 12), SFA- with sperm motility at 44.4%, and semen volume at 18.2% at the end of treatment. Subjects with BMI ≥ 25 kg/m(2) significantly improved in fat mass lost (P = 0.008). All safety parameters were comparable to placebo.

The Effect of Labisia pumila var. alata on Postmenopausal Women: A Pilot Study.

This is a randomized, double-blind, placebo-controlled study comparing the effects of a water extract of Labisia pumila var. alata at 280 mg/day with placebo, given for 6 months in postmenopausal Malay women. There were 29 patients treated with Labisia pumila and 34 patients in the placebo group. Menopausal symptoms were assessed at baseline and at 6 months. The blood pressure, body mass index, waist circumference, fasting blood sugar, lipid profile, and hormonal profile (follicle stimulating hormone/luteinizing hormone/estradiol) were measured during visits every two months. ANCOVA model analysis showed significantly lower triglycerides levels in LP subjects at 6 months after treatment as compared to placebo (1.4 versus 1.9 mmol/L; adj. mean difference 0.5, 95% CI: 0.02, 0.89 after adjusted for the baseline values, age, BMI, and duration of menopause placebo). Other parameters in both groups did not differ significantly. In conclusion, daily intake of Labisia pumila at 280 mg/day for six months was found to provide benefit in reducing the triglyceride (TG) values.

Risk Factors Associated with Defaulted Follow-Up and Sharp Injury Management among Health Care Workers in a Teaching Hospital in Northeastern Malaysia.

Sharp injury is a serious occupational risk for healthcare workers (HCWs). This study aimed to determine the distribution and associated factors of sharp injury cases among HCWs working at a teaching hospital in northeastern Malaysia. This was a retrospective cohort study on all reported sharp injury cases from 2015 to 2020. The secondary data were examined using descriptive and multiple logistic regression. Statistical significance was determined for associated factors of HCWs who did not attend immediate treatment after a sharp injury or any of the subsequent follow-up variables, with a p-value of less than 0.05. A total of 286 cases fulfilled the study criteria. The mean (SD) age of sharp injury was 29.4 (5.38) years. The overall defaulted rate for follow-up was 51.4%. Multiple logistic regression revealed a significant relationship between defaulted follow up on sharp injury management and job category as well as the type of device used. Being a doctor (Adj OR 2.37; 95% CI: 1.40, 4.03; p = 0.010) and those using other sharp instruments such as Coupland and drip sets (Adj OR 4.55; 95% CI: 1.59, 13.02; p = 0.005) had a higher odds to default follow up on sharp injury management. In conclusion, although there is a link between defaulting the follow-up and both the work category and the type of device that caused the injury, a deeper analysis is needed to uncover any additional factors and determine the appropriate intervention strategies to ensure follow up adherence.

Development and Validation of the Tuberculosis Risk Score for Smokers (TBRSS).

Tuberculosis (TB) remains a significant public health issue worldwide. However, the effectiveness of TB screening programmes among smokers is still questionable. There is a need for a simple, reliable, and validated screening system for this risk population. This study aimed to develop and validate the tuberculosis risk score for smokers (TBRSS) in Kelantan, Malaysia. A case-control study was conducted on 159 patients (smokers with and without TB) between January and July 2020. Simple and multiple logistic regressions were applied to determine the variables to be included in the risk score. The cut-off points to determine a score indicating low or high risk for TB disease were obtained based on the receiver operating characteristics curve. Content validation was carried out through interviews with eight experts to measure each variable's relevancy. The face validation was conducted among 20 health clinic staff. Seven variables were selected for inclusion in the risk score. The chosen cut-off point was 16 (out of 43), with 91% and 78% sensitivity and specificity, respectively. The scale-level content validity index was 0.83, while the face validity index scores for each element ranged between 0.85 and 1.00. The TBRSS can be considered a validated screening tool for use in screening TB disease risk among smokers, which potentially may lead to an increased detection of TB disease in the community.

Burden and Risk Factors of Melioidosis in Southeast Asia: A Scoping Review.

This scoping review aims to provide a comprehensive overview of human melioidosis in Southeast Asia as well as to highlight knowledge gaps in the prevalence and risk factors of this life-threatening disease using available evidence-based data for better diagnosis and treatment. Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) was used as the guideline for this review. The literature search was conducted on 23 March 2022 through two electronic databases (PubMed and Scopus) using lists of keywords referring to the Medical Subject Headings (MeSH) thesaurus. A total of 38 articles related to human melioidosis were included from 645 screened articles. These studies were carried out between 1986 and 2019 in six Southeast Asian countries: Thailand, Cambodia, Malaysia, Myanmar, Singapore, and Vietnam. Melioidosis has been reported with a high disease prevalence among high-risk populations. Studies in Thailand (48.0%) and Cambodia (74.4%) revealed disease prevalence in patients with septic arthritis and children with suppurative parotitis, respectively. Other studies in Thailand (63.5%) and Malaysia (54.4% and 65.7%) showed a high seroprevalence of melioidosis among Tsunami survivors and military personnel, respectively. Additionally, this review documented soil and water exposure, diabetes mellitus, chronic renal failure, thalassemia, and children under the age of 15 as the main risk factors for melioidosis. Human melioidosis is currently under-reported in Southeast Asia and its true prevalence is unknown.

Predictors of tuberculosis disease in smokers: a case-control study in northeastern Malaysia.

Objective: Tuberculosis (TB) is a leading infectious disease. However, many TB cases remain undetected and only present symptoms at a late stage of the infection. Therefore, targeted TB screening in high-risk populations, including smokers, is crucial. This study aimed to determine the predictors of TB disease among the smoker population in northeast Malaysia from 2019 to 2020. Methods: A case-control study was conducted involving smokers aged 18 years and older from health clinics in Bachok Kelantan, Malaysia. Data were collected via face-to-face interviews or telephone calls from 159 participants, randomly selected from outpatient TB records. Simple and multiple logistic regression, using R software, were used to identify the determinants of TB. Results: Most participants were male (59.1%) and had a secondary education (56.0%). Active smokers constituted 35.2% of the group, and the mean (SD) duration of exposure to smoking was 23.9 (16.47) and 18.4 (12.84) years for the case and control groups, respectively. Being an ex-smoker (adjusted odds ratio (AOR) 6.17; 95% CI [1.55-28.32]; p = 0.013), weight loss (AOR 13.45; 95% CI [4.58-44.46]; p < 0.005), night sweats (AOR 63.84; 95% CI [8.99-1392.75]; p < 0.005) and duration of symptoms (AOR 1.02; 95% CI [1.01-1.04]; p = 0.022) were shown to be significant predictors for TB disease. Conclusion: Four predictors of TB disease in the population of smokers were recognised in this study and should be prioritised for early TB screening and diagnosis. This may help increase TB detection, initiate prompt treatment and reduce complications among the group at risk for TB.

Subjective Wellbeing and Its Associated Factors among University Community during the COVID-19 Pandemic in Northern Malaysia.

Lockdown implementation during COVID-19 pandemic has caused many negative impacts in various aspect of life, including in the academic world. Routine disruption to teaching and learning environment has raised concerns to the wellbeing of university staff and students. This study aimed to examine the subjective wellbeing of the university community in Northern Malaysia during lockdown due to COVID-19 pandemic and the factors affecting it. An online cross-sectional survey involving 1148 university staff and students was conducted between March and April 2020. The research tools include the Personal Wellbeing Index (PWI) to assess subjective wellbeing and the Depression, Anxiety and Stress 21 (DASS-21) scale for psychological distress. While we found the subjective wellbeing score in our study population was stable at 7.67 (1.38), there was high prevalence of anxiety, depression, and stress with 27.4%, 18.4%, and 11.5%, respectively. The students reported higher levels of psychological distress compared to staff. The PWI score was seen to be inversely affected by the depression and stress score with a reduction in the PWI score by 0.022 (95% CI -0.037 to -0.007) and 0.046 (95% CI -0.062 to -0.030) with every one-unit increment for each subscale, respectively. Those who perceived to have more difficulty due to the lockdown also reported low subjective wellbeing. Thus, it is crucial to ensure policies and preventative measures are in place to provide conducive teaching and learning environment. Additionally, the detrimental psychological effects especially among students should be addressed proactively.

Low Seroprevalence of SARS-CoV-2 among Healthcare Workers in Malaysia during the Third COVID-19 Wave: Prospective Study with Literature Survey on Infection Prevention and Control Measures.

Healthcare workers (HCWs) are at greater risk for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. This serology surveillance study aimed to investigate the prevalence of SARS-CoV-2 antibodies among the HCWs who were asymptomatic during the third wave of COVID-19 in Malaysia. HCWs from the Universiti Sains Malaysia (USM) Health Campus were prospectively recruited between August 2020 and March 2021 on a voluntary basis. Data on socio-demographics, possible risk factors and travel history were recorded. Serological diagnoses from serum samples were examined for total antibodies against SARS-CoV-2 using an immunoassay kit. A literature survey was performed on the compliance with infection and prevention control (IPC) practices for COVID-19 among HCWs. The majority of the total 617 HCWs participating in this study were nurses (64.3%, n = 397), followed by health attendants (20.9%, n = 129), medical doctors (9.6%, n = 59) and others (6.3%, n = 39). Of those, 28.2% (n = 174) claimed to have exposure to COVID-19 cases, including history of close contact and casual contact with infected patients. Most importantly, all serum samples were found to be non-reactive to SARS-CoV-2, although nearly half (40.0%, n = 246) of the HCWs had been involved directly in the management of acute respiratory illness cases. A proportion of 12.7% (n = 78) of the HCWs reported having underlying health problems, such as diabetes mellitus, hypertension and hyperlipidemia. Despite the presence of medical and sociological risks associated with SARS-CoV-2 infections, the current study found zero prevalence of antibodies against SARS-CoV-2 among the HCWs of USM. Based on the literature survey, the vast majority of Malaysian HCWs demonstrated good IPC practices during the pandemic (average percentage ranged between 92.2% and 99.8%). High compliance with IPC measures may have led to the low seroprevalence of SARS-CoV-2 among the HCWs.

Effect of Diabetes Mellitus on Tuberculosis Treatment Outcomes among Tuberculosis Patients in Kelantan, Malaysia.

BACKGROUND: There is growing evidence that DM may play an important role in the occurrence of unsuccessful TB treatment outcomes. This study was undertaken to examine the prevalence of DM among TB population, compare the profile of TB patients with and without DM and determine the effect of DM on unsuccessful treatment outcomes among TB patients in Kelantan state, Malaysia from 2012 to 2016. METHODS: A cross sectional study was conducted in Sep 2017 using data from registered TB cases in Kelantan state, Malaysia from 2012 to 2016. The profile of TB patients with and without DM were compared in univariable analysis. Multiple logistic regression was used to determine association between DM and unsuccessful treatment outcomes. RESULTS: A total of 1854 TB patients were diagnosed with DM. The annual proportion was ranging from 26 to 29%. TB patients with DM had an older age, live single, low educational status, poor chest x ray finding and diagnosed with smear positive sputum compared to TB patients without DM. TB patients with DM had three times higher risk to develop unsuccessful TB treatment outcomes compared to TB patients without DM (95% CI 2.47-3.58; P = 0.012) in multivariable analysis. CONCLUSION: Those with DM had the worst prognosis of TB outcomes among the significant risk factors. TB control program in Malaysia will need to expand efforts to focus on treatment of TB-DM patients to improve their cure rates in order to achieve the goals of tuberculosis elimination.

Tualang honey ameliorates viral load, CD4 counts and improves quality of life in asymptomatic human immunodeficiency virus infected patients.

This is the first study to report on the effects of honey in asymptomatic HIV positive subjects in ameliorating CD4 count, viral load (VL) and quality of life (QOL). It is a randomized, controlled, open labelled study, comparing the effects of Tualang honey (TH) administration for six months at three different doses: 20 g (THL), 40 g (THI) or 60 g (THH) daily compared with control (no administered treatment, THC). Only asymptomatic HIV positive subjects (n=95) having CD4 count 250-600 cell/ml, not on antiretrovirals were enrolled. Blood, (together with QOL questionnaires administration) were investigated at baseline, three and six months (CD4 cell count) while VL was determined only at baseline and six months. Significant reductions in CD4 counts in THL and THC groups (p= 0.003 for both) were seen with no significant reductions in the CD4 counts in THI and THH groups (p=0.447 and 0.053 respectively). There was improvement in VL in THC and THI (130% and 32% respectively) and reductions in THL and THH (26% and 8% respectively). Within and between group analyses for VL indicated significant differences between THL and THH compared to THC. In addition, significant improvement in QOL of groups which received TH was noted. TH has the potential to improve the QOL (physical and psychological) and CD4 counts. There was a trend of lower VL in asymptomatic HIV subjects following TH administration thus supporting the possible role of TH in boosting the immune system by improving CD4 counts, causing VL reductions in HIV positive subjects.

Leptospirosis and Workplace Environmental Risk Factors among Cattle Farmers in Northeastern Malaysia.

BACKGROUND: Leptospirosis is an emerging zoonosis and its occurrence has been reported to be rising globally. The environment plays an important role in the survival of Leptospira and determines the risk of infection. Those who were exposed to and had contact with contaminated environment through their occupational, recreational and other activities can be infected with the organism. OBJECTIVE: To determine the seroprevalence of leptospirosis among cattle farmers, prevalence of pathogenic Leptospira, and the workplace environmental risk factors for leptospirosis among cattle farmers in northeastern Malaysia. METHODS: A cross-sectional study involving 120 cattle farmers was conducted. The participants answered an interviewer-guided questionnaire that consisted of sociodemographic and workplace environment characteristics questionnaire, before having their blood sample taken for microscopic agglutination test (MAT). Seropositivity was determined using a cut-off titer of ≥1:100. 248 environmental samples were also collected from the cattle farms for polymerase chain reaction (PCR). RESULTS: The overall seroprevalence of leptospiral antibodies was 72.5% (95% CI 63.5% to 80.1%) and the prevalence of pathogenic Leptospira in the cattle farms environment was 12.1% (95% CI 8.4% to 17.0%). The independent factors associated with seropositivity of leptospirosis among cattle farmers were positive pathogenic Leptospira in the environment (Adj OR 5.90, 95% CI 1.34 to 26.01) and presence of garbage dumping in the farm (Adj OR 2.40, 95% CI 1.02 to 5.65). CONCLUSION: Preventing leptospirosis incidence among cattle farmers necessitates changes in work environment. Identifying modifiable factors may also contribute to the reduction of infection.

Factors influencing transfusion requirement in patients undergoing first-time, elective coronary artery bypass graft surgery.

CONTEXT: Coronary artery bypass graft (CABG) operation is associated with high frequency of allogeneic blood transfusion due to the acquired hemostatic challenges in patients undergoing CABG. However, allogeneic blood transfusion carries risks of infection, adverse reaction, and mortality as well as prolonged hospital stay and increased hospital cost. It is important to identify patients who require blood transfusion to mitigate their risk factors and reduce the chance of exposure to allogeneic blood. AIMS: This study was conducted to evaluate factors that influence the decision to transfuse red cell in first-time elective CABG patients. SETTINGS AND DESIGN: This was a cross-sectional study based on a retrospective record review. The study was done in the National Heart Institute. MATERIALS AND METHODS: All patients who underwent first-time elective CABG were included in this study. Variables analyzed include age, gender, body weight, preoperative hemoglobin (Hb) level, patients' comorbidities, and other clinical parameters. STATISTICAL ANALYSIS USED: Data were analyzed using SPSS software version 20. RESULTS: A total of 463 patients underwent first-time elective CABG during the period of the study. Three hundred and eighty-six (83.4%) patients received red cell transfusion. From multiple logistic regression analysis, only age (odds ratio [OR] = 1.040, 95% confidence interval [CI]: 1.003, 1.077, P = 0.032), body weight (OR = 0.951, 95% CI: 0.928, 0.974, P < 0.001), Hb level (OR = 0.500, 95% CI: 0.387, 0.644, P < 0.001), and cardiopulmonary bypass time (OR = 1.013, 95% CI: 1.004, 1.023, P < 0.001) were the significant independent predictors of red cell transfusion. CONCLUSIONS: By stratifying patients according to their risk factor for red cell transfusion, the high-risk patients could be recognized and should be enrolled into effective patient blood management program to minimize their risk of exposure to allogeneic blood transfusion.

Exposure to environmental microbiota explains persistent abdominal pain and irritable bowel syndrome after a major flood.

BACKGROUND: After an environmental disaster, the affected community is at increased risk for persistent abdominal pain but mechanisms are unclear. Therefore, our study aimed to determine association between abdominal pain and poor water, sanitation and hygiene (WaSH) practices, and if small intestinal bacterial overgrowth (SIBO) and/or gut dysbiosis explain IBS, impaired quality of life (QOL), anxiety and/or depression after a major flood. RESULTS: New onset abdominal pain, IBS based on the Rome III criteria, WaSH practices, QOL, anxiety and/or depression, SIBO (hydrogen breath testing) and stools for metagenomic sequencing were assessed in flood victims. Of 211 participants, 37.9% (n = 80) had abdominal pain and 17% (n = 36) with IBS subtyped diarrhea and/or mixed type (n = 27 or 12.8%) being the most common. Poor WaSH practices and impaired quality of life during flood were significantly associated with IBS. Using linear discriminant analysis effect size method, gut dysbiosis was observed in those with anxiety (Bacteroidetes and Proteobacteria, effect size 4.8), abdominal pain (Fusobacteria, Staphylococcus, Megamonas and Plesiomonas, effect size 4.0) and IBS (Plesiomonas and Trabulsiella, effect size 3.0). CONCLUSION: Disturbed gut microbiota because of environmentally-derived organisms may explain persistent abdominal pain and IBS after a major environmental disaster in the presence of poor WaSH practices.

Mood and memory function in ovariectomised rats exposed to social instability stress.

This study aims to compare the effects of social instability stress on memory and anxiety- and depressive-like behaviour between sham-operated controls and ovariectomised (OVX) rats. Forty adult female Sprague-Dawley rats (8 weeks old) were randomly divided into four groups, (n = 10 per group). These were non-stressed sham-operated control rats, stressed sham-operated control rats, non-stressed OVX rats, and stressed OVX rats. The rats were subjected to social instability stress procedure for 15 days. Novel object recognition, open field, and forced swim tests were conducted after the stress procedure. Serum estradiol, ACTH and corticosterone levels were measured using commercially available ELISA kits. Lower serum estradiol level and uterine weight with higher weight gain were observed in OVX rats compared to sham-operated controls. Serum ACTH, and corticosterone levels were higher in stressed compared to non-stressed groups. Memory deficit and anxiety- and depressive-like behaviour were significantly increased in stressed compared to non-stressed OVX rats but these changes were not seen in sham-operated controls. These results suggest that the high circulating corticosterone acts synergistically with low circulating estradiol to exert negative effects on mood and memory function.